PATIENTS with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) face a significant risk of severe and often fatal infections, according to a new multicenter prospective study. Over an average follow-up of nearly five years, 96% of the 148 patients studied experienced at least one severe infection, with respiratory infections being the most prevalent and deadly. The study recorded an alarming infection incidence rate of 52.6 per 100 person-years, and infections were the cause of death for 65% of the 48 patients who died during the study.
The most common culprits behind these infections were respiratory pathogens such as SARS-CoV-2, Streptococcus pneumoniae, Pseudomonas aeruginosa, and the influenza A virus. Factors like advanced age, active inflammation, and treatments involving corticosteroids and immunosuppressants were linked to an increased risk of both infection and mortality.
The findings stress the need for comprehensive and preventive medical strategies for patients with RA-ILD, who are particularly vulnerable to recurrent and life-threatening infections. This study highlights the importance of vigilant monitoring, timely vaccination, and careful management of immunosuppressive therapies to reduce infection-related complications.
Aleksandra Zurowska, EMJ
Reference
Mena-Vázquez et al. Rate of severe and fatal infections in a cohort of patients with interstitial lung disease associated with rheumatoid arthritis: a multicenter prospective study. Front Immunol. 2024;15.
